. Abdominal hernia : its diagnosis and treatment. Retained testicle, figs. 127 and 128 ; sac opened- Omentum in right hand, testicle within sac in left hand. it can be accomplished, is desirable. (In the case shown in and 128, the sac was full of omentum, which was ampu-tated and the stump reduced, leaving the testicle showing from Fig. Sac cut away from testicle, ready to tie with purse-string suture. Should be closer toperitoneal surface than here shown. the inside of the sac as seen in fig. 130.) The neck of sac(really the tunica vaginalis) must be gradually worked away 248 A
. Abdominal hernia : its diagnosis and treatment. Retained testicle, figs. 127 and 128 ; sac opened- Omentum in right hand, testicle within sac in left hand. it can be accomplished, is desirable. (In the case shown in and 128, the sac was full of omentum, which was ampu-tated and the stump reduced, leaving the testicle showing from Fig. Sac cut away from testicle, ready to tie with purse-string suture. Should be closer toperitoneal surface than here shown. the inside of the sac as seen in fig. 130.) The neck of sac(really the tunica vaginalis) must be gradually worked away 248 ABDOMINAL HERNIA. from the cord just where the vessels leave it to dip down intothe pelvic cavity, and a ligature is either passed around it, or apurse-string suture is placed from its inside, and it is cut awayfrom the cord and testicle ( figs. 131, 132). If it is now decidedthat the cord is too short to allow of the testicle being placed inthe top of the scrotum, the fingers should be run under theinternal oblique and transversalis muscles towards the medianline, forming a pocket between these structures and the peri-toneum (fig. 133). In this pocket the testicle is then placedand the canal entirely obliterated by closing it according to Fig. 132.
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